This invention relates to a laparoscopic surgical device and a related surgical technique.
Laparoscopy involves the piercing of a patient's abdominal wall and the insertion of a cannula through the perforation. Generally, the cannula is a trocar sleeve which surrounds a trocar during an abdomen piercing operation. Upon the formation of the abdominal perforation, the trocar is withdrawn while the sleeve remains traversing the abdominal wall. A laparoscopic instrument, such as a laparoscope or a forceps, is inserted through the cannula so that a distal end of the instrument projects into the abdominal cavity.
Generally, in a laparoscopic surgical procedure, three or four perforations are formed in the abdomen to enable deployment of a sufficient number of laparoscopic instruments to perform the particular surgery being undertaken. Each perforation is formed by a trocar which is surrounded by a sleeve, the sleeves or cannulas all remaining in the abdominal wall during the surgical procedure.
Prior to insertion of the first trocar and its sleeve, a hollow needle called a "Veress needle" is inserted through the abdominal wall to enable pressurization of the abdominal cavity with carbon dioxide. This insufflation procedure distends the abdominal wall, thereby producing a safety space above the patient's abdominal organs.
A problem with this insufflation procedure is that the surgeon has little information for determining the location of the distal end of the Veress needle. Consequently, the carbon dioxide is sometimes injected into the abdominal wall, which results in a subcutaneous emphezema, or into the intestine. The latter eventuality is particularly dangerous in that, subsequently to an inflation of the intestine by carbon dioxide, a trocar is sometimes inserted into the intestine, resulting in a substantial perforation.